Culturally Competent Nursing

Many nurses might regard a patient who refuses to take a certain medication, constantly has a roomful of visitors or demands that a family member feed him as noncompliant. However, nurses who dig deeper may discover these behaviors are a product of the patient’s cultural beliefs and values – deep-rooted ideologies that nurses can preserve or accommodate.

“To be a true patient advocate, a nurse needs to be culturally aware,” says Sue Hasenau, RN, MSN, a certified neonatal nurse practitioner and member of the TransCultural Nursing Society.

Providing effective, sensitive healthcare for patients of other cultures requires empathy, flexibility and a commitment to continuous learning. How can nurses successfully work with and care for the nation’s increasingly diverse patient population? Here are some general guidelines:

Don’t Make Assumptions

Patients from other parts of the world may experience entirely different medical issues than US patients. Gihan ElGindy, RN, MSN, executive director of the Transcultural Educational Center in McLean, Virginia, learned this firsthand when she developed a breast-cancer awareness program for recent immigrants from areas in Africa, the Middle East and Asia that are virtually cancer-free. While many of the 500 women in the program had never heard of breast cancer, their risk level increases the longer they live in the US. “Our American literature says these groups of women are ignorant or don’t comply,” ElGindy says. “But why [would] they have to know about cancer if it doesn’t exist in their countries?”

Explain Every Detail

Healthcare jargon is especially difficult for people whose native language is not English. The women in the breast-cancer program, for instance, had “no clue about the American terminology we use but were too shy to say they didn’t understand,” ElGindy relates. For example, when one of the questions on ElGindy’s initial survey asked, “Do you have Medicare or Medicaid?” some respondents assumed that Medicaid and Medicare were forms of cancer.

Ask About Alternative Approaches to Healing

Many people from other cultures seek herbal remedies from traditional healers, says medical anthropologist Geri-Ann Galanti, PhD, author of Caring for Patients from Different Cultures and founder of the Web site Cultural Diversity in Healthcare. Some herbal remedies may be harmful or interact poorly with Western medicine, so it’s especially important that nurses ask about these alternative treatments.